| Atazanavir | Pitavastatin | Possibly ↑ pitavastatin effects | | Start at lowest dosage and titrate to effect |
Atazanavir
(atazanavir 300 mg QD with ritonavir 100 mg QD) | Rosuvastatin | ↑ rosuvastatin effects | | Do not coadminister
Alternative agents:
pravastatin, atorvastatin |
| Darunavir | Buprenorphine | | Inhibition of CYP450 3A4 by darunavir/ritonavir | No dosage adjustment necessary |
| Darunavir | Methadone | May ↓ methadone effects (eg, withdrawal) | | Monitor for signs and symptoms of methadone withdrawal; some patients may need ↑ in the methadone dosage |
| Darunavir | Nevirapine | Possibly ↑ darunavir effects; possibly ↑ nevirapine effects | | No dosage adjustment necessary |
| Darunavir | Rifabutin | ↑ darunavir and rifabutin effects | Inhibition of CYP450 3A4 by darunavir | ↓ rifabutin dosage to 150 mg QOD when combined with darunavir/ritonavir |
| Darunavir | Rosuvastatin | No change in lipid-lowering ability within 35-day study period | | Avoid coadministration if possible; if used, use caution and start at 5 mg daily |
Efavirenz
(400 mg QD)
| Proguanil
(300 mg, single dose)
| Possibly ↓ antimalarial effects | Possible inhibition of CYP450 2C19 by efavirenz; possible induction of P-gp by efavirenz | Dosage adjustment not established |
Efavirenz
(600 mg QHS)
| Proguanil
(100 mg with 250 mg atovaquone, single dose)
| | ↑ atovaquone glucuronidation; induction of CYP450 3A4 by efavirenz | Dosage adjustment not established |
Etravirine
(200 mg BID with darunavir/ritonavir 600/100 mg BID)
| Maraviroc | ↑ maraviroc effects | Inhibition of CYP450 3A4 by darunavir/ritonavir | ↓ maraviroc to 150 mg BID |
Etravirine
(200 mg BID)
| Maraviroc | | Induction of CYP450 3A4 by etravirine | ↑ maraviroc to 600 mg BID when used with etravirine |
| Fosamprenavir | Paroxetine | ↓ paroxetine effects | | Titrate paroxetine to effect |
| Fosamprenavir | Rosuvastatin | | | No dosage adjustment necessary |
| Indinavir | Atovaquone | | | No dosage adjustment necessary |
| Lopinavir/ritonavir | Bupropion | ↑ bupropion effects | Possible induction of CYP450 2B6 and UGT enzymes | |
| Lopinavir/ritonavir | Echinacea | | | No dosage adjustment necessary |
| Lopinavir/ritonavir | Ketoconazole | ↑ ketoconazole effects; ↓ lopinavir/ritonavir effects | | Manufacturer recommends against using high dosages of ketoconazole (>200 mg daily)
Alternative agents:
fluconazole
|
| Lopinavir/ritonavir | Rosuvastatin | ↑ rosuvastatin effects | | Do not coadminister
Alternative agents:
pravastatin, atorvastatin
|
| Maraviroc | Raltegravir | | | No dosage adjustment necessary |
| Raltegravir | Antacids | | | No dosage adjustment necessary |
| Ritonavir | Colchicine | ↑ colchicine effects | Inhibition of CYP450 3A4 by ritonavir | For treatment of gout, ↓ colchicine dosage to 0.6 mg for a single dose, then 0.3 mg 1 hour later; dose not to be repeated earlier than 3 days; for prophylaxis of gout, ↓ colchicine dosage to 0.3 mg QD if on 0.6 mg BID prior to PI therapy or ↓ colchicine dosage to 0.3 mg QOD if on 0.6 mg QD prior to PI therapy |
Ritonavir
(200 mg BID)
| Tadalafil | ↑ tadalafil effects (eg, hypotension, priapism) | Inhibition of CYP450 3A4 by ritonavir | Do not exceed 10 mg tadalafil every 72 hours |
Ritonavir
(500 mg or 600 mg BID)
| Tadalafil | ↑ tadalafil effects (eg, hypotension, priapism) | Inhibition of CYP450 3A4 by ritonavir | Do not exceed 10 mg tadalafil every 72 hours |
| Zidovudine | Atovaquone | ↑ zidovudine effects | Inhibition of glucuronidation by atovaquone | No dosage adjustment necessary |
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